{OVERALL_HEADER}<table width="780" border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td valign="top"><br>
      <form name="form1" method="post" action="">
        <table border="0" cellpadding="0" cellspacing="0">
          <tr class="normal">
            <td width="150">{LANG_NAMECOM}:</td>
            <td><input name="name" type="text" id="name" size="42" value="{NAME}" style="width:300px;"></td>
          </tr>
          <tr class="normal">
            <td>{LANG_YEMAIL}:</td>
            <td><input name="email" type="text" id="email" size="42" value="{EMAIL}" style="width:300px;"></td>
          </tr>
          <tr class="normal">
            <td>{LANG_YUSERNAME}:</td>
            <td><input name="username" type="text" id="username" size="42" value="{USERNAME}" style="width:300px;"></td>
          </tr>
          <tr class="normal">
            <td>{LANG_ACCTYPE}:</td>
            <td><select name="type" id="type" style="width:300px;">
                <option IF("{TYPE}" == "provider"){selected}>{LANG_PROVIDERU}</option>
                <option IF("{TYPE}" == "buyer"){selected}>{LANG_BUYERU}</option>
            </select></td>
          </tr>
          <tr class="normal">
            <td>&nbsp;</td>
            <td></td>
          </tr>
          <tr class="normal">
            <td>{LANG_SUBJECT}:</td>
            <td><input name="subject" type="text" id="subject" size="42" style="width:300px;"></td>
          </tr>
          <tr class="normal">
            <td valign="top">{LANG_MESSAGE}:</td>
            <td><textarea name="message" cols="32" rows="6" id="message" style="width:300px;"></textarea></td>
          </tr>
          <tr class="normal">
            <td>&nbsp;</td>
            <td></td>
          </tr>
          <tr>
            <td>&nbsp;</td>
            <td><input type="submit" name="Submit" value="{LANG_CONTUS}"></td>
          </tr>
        </table>
      </form>
      <br></td>
  </tr>
</table>
{OVERALL_FOOTER}